Geriatric Nursing Commons^™

Assessing The Psychoeducational Approach To Transcendence And Health (Path) Program : An Intervention To Foster Self-Transcendence And Well-Being In Community-Dwelling Older Adults., Valerie Lander Mccarthy, Sharon Bowland, Lynne A. Hall, Jennifer Connelly

Faculty Scholarship

The late-life developmental process of self-transcendence shapes elders’ perspectives on self, others, the nature of this world, and of a dimension beyond the here and now. This qualitative pilot study evaluated the Psychoeducational Approach to Transcendence and Health (PATH) Program, a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling women at a senior center. The intervention involved eight weekly group sessions using group processes, mindfulness practices, creative experiences, and independent at-home practice. The findings supported the underlying theory-based structure and content of the intervention and indicated the intervention may empower elders to attend to self-care, develop acceptance, and learn …

Perceived Barriers To Infection Prevention And Control For Nursing Home Certified Nursing Assistants: A Qualitative Study., Jasmine Travers, Carolyn T A Herzig, Monika Pogorzelska-Maziarz, Eileen Carter, Catherine C Cohen, Patricia K Semeraro, Ragnhildur I Bjarnadottir, Patricia W Stone

College of Nursing Faculty Papers & Presentations

Healthcare-associated infections, while preventable, result in increased morbidity and mortality in nursing home (NH) residents. Frontline personnel, such as certified nursing assistants (CNAs), are crucial to successful implementation of infection prevention and control (IPC) practices. The purpose of this study was to explore barriers to implementing and maintaining IPC practices for NH CNAs as well as to describe strategies used to overcome these barriers. We conducted a multi-site qualitative study of NH personnel important to infection control. Audio-recorded interviews were transcribed verbatim and transcripts were analyzed using conventional content analysis. Five key themes emerged as perceived barriers to effective IPC …

The Lived Experience Of Aging: Listening To The Oldest-Old, Julia A. Pusztai

Loma Linda University Electronic Theses, Dissertations & Projects

Although embraced as desirable by most, living into very old age is largely unexplored as a distinct season of life, with increased, varied, and cumulative changes during a unique time of vulnerability and frailty. The purpose of this study was to listen to the oldest-old, and to explore their lived experience of growing old. This hermeneutic phenomenology study examines the experience of finding meaning and living with losses and gains in advanced old age. This study design included three separate interviews one month apart with participants over 85 years of age. Purposive sampling resulted in 13 participants, 5 being male …

A Mindfulness And Health Promotion Program To Decrease The Perception Of Stress And Burnout In Psychiatric Mental Health Nurses Who Provide Driect Patient Care To Individuals In Mental Health Units With A Diagnosis Of Alzheimer's Type Dementia, Latarsha Waltronia Bilal Edwards

LaTarsha W Edwards

The principle of this systems-change project is to employ a stress management and health promotion program in Alzheimer’s type units to decrease the perception of stress and burnout in psychiatric-mental health nurses providing direct care in secured units. This systems-change project will implement mindfulness techniques as an effective tool for reducing the perception of stress and burnout. The mindfulness-based stress reduction and burnout prevention program will be implemented into staff development programs for nurses working in locked and psychiatric units in the community. Mindfulness-based stress reduction is an operational tool to aid nurses psychologically and to increase work satisfaction. Behavioral …

Understanding Infection Prevention And Control In Nursing Homes: A Qualitative Study., Patricia W. Stone, Carolyn T.A. Herzig, Monika Pogorzelska-Maziarz, Eileen Carter, Ragnhildur I. Bjarnadottir, Patricia K. Semeraro, Catherine C. Cohen, Jasmine Travers, Steven Schweon

College of Nursing Faculty Papers & Presentations

Infections have been identified as a priority issue in nursing homes (NHs). We conducted a qualitative study purposively sampling 10 NHs across the country where 6-8 employees were recruited (N = 73). Semi-structured, open-ended guides were used to conduct in-depth interviews. Data were audiotaped, transcribed and a content analysis was performed. Five themes emerged: 'Residents' Needs', 'Roles and Training' 'Using Infection Data,' 'External Resources' and 'Focus on Hand Hygiene.' Infection prevention was a priority in the NHs visited. While all sites had hand hygiene programs, other recommended areas were not a focus and many sites were not aware of available …

Promoting Self-Transcendence And Well-Being In Community-Dwelling Older Adults : A Pilot Study Of A Psychoeducational Intervention., Valerie Lander Mccarthy, Jiying Ling, Sharon Bowland, Lynne A. Hall, Jennifer Connelly

Faculty Scholarship

Self-transcendence changes how older adults perceive themselves, their relationships with others, the material world, and the metaphysical or spiritual dimension. It is associated with multiple indicators of well-being. The purpose of this pilot study (N = 20) was to examine the feasibility and effectiveness of a psychoeducational intervention to increase self-transcendence and well-being of older adults. Data were analyzed using generalized estimating equations. All variables trended in the directions hypothesized. Self-transcendence increased in the intervention group and decreased in the control group but not significantly. The group × time interaction for life satisfaction was significant (z = 2.89, …

Psychometric Properties Of The Family Caregiver Delirium Knowledge Questionnaire, Margaret J. Bull, Jennifer M. Sjostedt, Lesley Boaz, Debra Oswald

College of Nursing Faculty Research and Publications

A valid, reliable measure of family caregivers’ knowledge about delirium was not located in the literature; such an instrument is essential to assess learning needs and outcomes of education provided. The purpose of the current study was to (a) develop a family Caregiver Delirium Knowledge Questionnaire (CDKQ) based on the Symptom Interpretation Model; and (b) establish validity and reliability of the measure. The 19-item CDKQ was developed and administered to 164 family caregivers for community-dwelling older adults. Descriptive statistics were examined for all variables. Psychometric testing included confirmatory factor analysis, item-to-total correlations, and internal consistency reliability. A three-factor model provided …

Alumna's Dedication To Nursing Spans 50 Years

DePaul Magazine

2014 marked the 20th anniversary of Professional Healthcare Resources for founder and president Eileen DeCesare (LAS MS ’78). Her home health care, hospice and personal care services organization in Washington, D.C. that was one of a handful of agencies preapproved to take affected patients when a health care fraud crackdown in 2014 closed 10 agencies. DeCesare talks about her nursing career and the legacy she hopes to leave.

Instituting Patient-Self Test Meters In Adults On Warfarin In A Cardiology Practice, Melvyn Grace Manzano Rabanal

Doctor of Nursing Practice Final Manuscripts

Background: Warfarin is the oral anticoagulant that is most commonly used to control and prevent thromboembolic disorders. It requires meticulous testing and dosing adjustments to attain therapeutic international normalized ratio (INR) levels. Patient self-testing (PST) is associated with a reduced risk of all-cause mortality and lower rates of thromboembolism and bleeding. PST meters offers convenience and promotes self-initiative of care.

Purpose: The purpose of the project is to evaluate the effectiveness of INR PST in adult patients diagnosed with atrial fibrillation, deep vein thrombosis, and mechanical heart valve on warfarin therapy in a Cardiology practice compared to traditional …

Telephone Calls To Reduce 30-Day Readmissions For Older Adults With Heart Failure, Juanette G. Clark

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of this evidenced based practice project was to evaluate the effectiveness of discharge follow-up calls for heart failure (HF) patients recently discharged from a private hospital.

Background: HF is the number one discharge diagnosis among patients 65 years and older. It affects 5.8 million people in the United States. HF admissions total (1) million annually, however, 24% of these patients are readmitted within 30 days of discharge. Re-hospitalizations are associated with high mortality rates and expenditures approximated at $13,000 per patient contributing to the overall annual expenditure of $33.7 billion. In 2012, the Centers for Medicare …

Improving Dental Care To The Elderly In A Nursing Home, Cara M. Licavoli

Master's Projects and Capstones

The project is about the collaboration between Peninsula Health Care District (PHCD) and Apple Tree Dental (ATD) in a team approach to address the current issues of improving dental care of frail and elderly patients in nursing home facilities. The specific aim is to improve dental care of clients at the San Mateo County nursing home facility by 100% by May, 2015. The methods use in this project was the adaptation and implementation of existing dental/oral health assessment tools, that is nurse driven for patient assessment upon admission to the nursing facility. The process includes staff education regarding the adapted …

Improving Patient Safety: Reducing Medication Errors In The Microsystem, Erica M. Dent

Master's Projects and Capstones

In a 72-bed for-profit long-term acute care hospital located in an urban setting, there has been a fifteen percent increase of medication errors that the pharmacy department has detected across nursing, and pharmacy departments, as well as with physicians from both day and night shifts. Over the last month there has been a total of twenty-eight medication errors including the transcription, administration, evaluation, and documentation processes. The microsystem consists of a telemetry/medical-surgical unit as well as a small intensive care unit consisting of ten beds.

The prospectus details a project implemented to reduce medication errors within the microsystem. The steps …

Factors Contributing To Registered Nurse Job Satisfaction In The Nursing Home, Michael Shipley

Seton Hall University Dissertations and Theses (ETDs)

Over the next several years the aging population will increase the number of patients suffering from chronic illness. A sicker aging population, coupled with changes in healthcare reimbursement will require nursing homes to admit sicker patients for shorter lengths of stays. To meet the needs of the increased number of chronic patients and those patients with higher acuities, nursing homes will require more skilled, registered nurses. Registered nurses (RNs) are the linchpin to providing high-quality care in the healthcare environment and especially in nursing homes.

Understanding the factors of RN job satisfaction in the nursing home is important in increasing …

Gap In Patient Expectations Of Deep Brain Stimulation For The Treatment Of Parkinson's Disease, Colleen D. Knoop Dnp-C

Graduate Theses, Dissertations, and Capstones

Abstract

Purpose: This project studied a specific group of patients with Parkinson’s disease to: determine if they were asked to verbalize expectations of DBS pre-operatively; determine if patient expectations were met post-operatively; gain information that could aid in improved pre-operative patient education for deep brain stimulation (DBS), address unrealistic expectations before surgery, and meet patient expectations post-operatively.

Methodology: This study was a retrospective, single academic center, two-part design that included a questionnaire and chart review of 29 patients. Those included were patients with Parkinson’s disease who had DBS programming at the academic center, between the years 2007 and 2014.

Results: …

Using Education And A Prevention Protocol Tool To Decrease The Incidence Of Pressure Ulcers In A Nursing Home, Kristina L. Scalzitti

Evidence-Based Practice Project Reports

Over 1.3 million persons are residents in nursing homes (NHs); one in ten have pressure ulcers. The purpose of this evidence based practice project was to determine if implementation of a pressure ulcer prevention tool, along with staff education, decreases the incidence of pressure ulcers within the NH. Florence Nightingale’s Environmental Model and the Stetler Model were used to guide this project. The setting was a NH in northwest Indiana. Eleven nurses attended a 15 minute educational session on pressure ulcer prevention and implementation of the Pressure Ulcer Prevention Protocol Intervention (PUPPI) tool. PowerPoint slides were distributed and flyers about …

Advanced Practice Nurses Knowledge And Use Of Fall Prevention Guidelines, Katherine Hays

Doctor of Nursing Practice Scholarly Projects

Falls are a significant public health issue resulting in a significant economic and social burden on society. Specific strategies are available that can reduce the risk of falling for older adults age 65 and older; however, providers have failed to integrate these guidelines into clinical practice (Rubenstein, Solomon & Roth, 2004; Chou, Tinetti, King, Irwin, & Fortinsky, 2006; Jones, Ghosh, Horn, Smith, & Vogt, 2011). The CDC has published the STEADI toolkit, a healthcare resource for integrating fall prevention guidelines into clinical practice; but little information is available on the knowledge and use of the STEADI toolkit by Advance Practice …

Use Of Dietary And Herbal Supplements In Older Adults With Osteoarthritis, Sharon Denise Mcdonald

Dissertations

Over the past several decades, older adults with Osteoarthritis (OA) have increasingly used more natural products in an effort to manage chronic pain. The theoretical framework for this study was the Lazarus and Folkman transactional theory of stress and coping. This framework was chosen based on the belief that older adults with OA are taking natural products as an active problem solving coping strategy to manage the pain, disability, and alterations they experience in their health related quality life including functional status, physical symptoms, emotional health, and social functioning. Older adults also take prescription medications for Osteoarthritis and a variety …

Impact Of Implementing The Geriatric Resource Nurse Model On Fall And Hospital Acquired Pressure Ulcer Rates, And Length Of Stay In Older Adults In An Acute Care Hospital, Elzbieta Kmiecik, Cathie E. Guzzetta, Mary-Michael Brown, Qiuping Pearl Zhou, Desale Sameer

GW Research Days 2015

Background.Older adults are at high risk for adverse care outcomes, such as injuries from falls, hospital acquired pressure ulcers (HAPUs), and prolonged length of stay (LOS). Available evidence suggests outcomes may improve when older adults are cared for by healthcare providers with competence in geriatrics. To improve outcomes, an acute care not-for-profit teaching hospital in Washington DC area implemented a Geriatric Resource Nurse (GRN) model that prepares registered nurses (RNs) as clinical experts on core geriatric principles on four general care wards (three medical-surgical and one cardiac).

Objectives. Toexamine the effects of GRN model implementation on fall and …

Oral Wellness: Using Occupational Therapy To Enhance Oral Hygiene Delivery In Long-Term Care, Lauryn J. Banovitz, Liberty Bellah, Rosemarie Lion

Dissertations, Masters Theses, Capstones, and Culminating Projects

Based on current literature, oral health in long-term care (LTC) facilities is frequently of low priority and does not follow evidence-based best practices. Poor oral health reduces the quality of life of older adult residents and patients and can lead to systemic diseases, such as cardiovascular disease, stroke, and pneumonia, the leading cause of death in LTC. Occupational therapists can play an instrumental role as oral care consultants, and educators, and can act as resource guides to raise the standards of oral care in LTC facilities.

This capstone project explored ways in which occupational therapy, a profession traditionally designated for …

Connecticut's Elderly Population: An In-Depth Analysis Of Current And Future Trends In Elder Care, With A Focus On Dementia And Cognitive Decline, Emily J. Snodgrass

Honors Scholar Theses

The aging population in Connecticut currently represents ~15% of the state’s population but is anticipated to rapidly increase over the next 20 years. My thesis is an examination of the types of interventions and programs currently available for elderly persons with memory impairment and cognitive decline, as well as the challenges associated with caring for a larger elderly population. Data collected from interviews with CT healthcare and research professionals representative of the diverse specialties of aging together with an analysis of current research literature are used to demonstrate the importance of continued research and expansion of appropriate and accessible services …